As the responsible parent/guardian of the applicant, I hereby certify that the application information provided on this form is current, true and correct to the best of my knowledge.
I hereby waive, release and discharge any and all claims for damages, death, personal injury or property damage which I may have or which may hereafter accrue to me as a result of my child's participation in Kay's Kamp activities. Your agreement discharges in advance Kay's Kamp and all of its agents, representatives, volunteers and employees from any and all liability, claims, costs, expenses and/or damages (collectively referred to as “liability”) arising out of or connected in any way with my child's participation in the activities of Kamp, even through that liability may arise out of negligence or carelessness on the part of the person or entities mentioned above.
I further understand that serious accidents occasionally occur during Kamp activities, and that participation in Kamp activities occasionally sustain mortal or serious personal injuries and/or property damage as a consequence thereof. Knowing the risks of Kamp activities, nevertheless, I hereby agree to assume those risks and to release and hold harmless all of the persons or entities mentioned above who (through negligence or carelessness) might otherwise be liable to my child or to me (or to my heirs or assigns) for damages.
I further agree to indemnify and hold harmless Kay's Kamp in the event or for any other damages any other person, property damages or entity, other than the undersigned, brings an action for the death or personal injuries of my child, as a result of my child's participation in Kay's Kamp activities.
I understand that Kay's Kamp accepts no responsibility for the loss, damage or theft of my child's property.
I agree that if I should not be readily available during the Kamp week, I will advise and keep the Kamp Administration team informed of where I can be contacted in the event of an emergency.
I understand that Kay's Kamp maintains an accident insurance policy on kampers attending the 2017 summer session and that all claims under this policy must be submitted within 30 days of the occurrence of the accident. This policy is in addition to and not in place of health or accident insurance maintained by you.
I recognize and understand that Kay's Kamp is operated as a charitable organization and that my child and I are receiving all of the benefits of Kay's Kamp with minimal or no cost to us.
I hereby give my permission to the Kay's Kamp medical team to administer routine and prescribed medications/treatments for my child as well as any emergency care required. In case of a medical and/or surgical emergency, I authorize Kay's Kamp medical staff to render to my child or to arrange for my child to receive any x-rays, anesthetic, medical, dental, surgical diagnosis, treatment, and hospital care which is deemed advisable by and is rendered under, the supervision of any physician, dentist, surgeon or nurse practitioner licensed to practice in the State of Delaware. I agree to be responsible for all medical transportation and related charges incurred on behalf of my child. I further agree that no Kay's Kamp employee, agent or volunteer will be responsible for injuries or damages arising from the provisions of such emergency treatment or transportation.
I acknowledge that reporters, photographers and other members of the media may attend Kay's Kamp in order to increase the awareness about Kay's Kamp and its programs. I grant permission for my child to be interviewed, photographed and filmed by any member of the media at Kay's Kamp. I understand that Kay's Kamp is not responsible for the content of the media coverage and that my child will not be paid for any media work.
Kay's Kamp and its representatives have absolute permission to use my child's image in a photograph or video that pertains to the lawful programs and activities of the Kamp.
I authorize my child to engage in all Kamp Activities, except as noted in writing by me or by the physician or PNP completing the Physician/PNP Recommendations and Restrictions form for my child.
If my application is for a Leader-In-Training (LIT) position, I authorize Kay's Kamp to obtain information pertaining to any charges my child may have for federal and state criminal law violations. This information will include convictions committed upon minors and adults and will be gathered from any law enforcement agency of this state or any other state or federal government to the full extent permitted by law. I understand that such access is for the purpose of considering my application as a volunteer and that I expressly DO NOT authorize the Kamp, its' directors, officers, employees or other volunteers to disseminate this information in any way to any other individual, group, agency, organization, or corporation.